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NPI Code Detail

MEDICARE: MICHAEL H LEE D.D.S.INC

MEDICARE: MICHAEL H LEE D.D.S.INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist28747CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1B2874701OTHERCADENTICAL,CALIFORNIA

General Provider Information

NPI Number : 1508065301
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHAEL H LEE D.D.S.INC
Provider Business Mailing Address
First Line : 19745 COLIMA RD STE 10
Second Line :
City : ROWLAND HEIGHTS
State : CA
Zip : 91748-3219
Country : US
Telephone Number : 909-594-9303
Fax Number : 909-594-8713
Provider Business Practice Location Address
First Line : 19745 COLIMA RD STE 10
Second Line :
City : ROWLAND HEIGHTS
State : CA
Zip : 91748-3219
Country : US
Telephone Number : 909-594-9303
Fax Number : 909-594-8713
Authorized Official
Title or Position : PRESIDENT
Name : DR. MICHAEL HECHAN LEE
Credential : D.D.S
Telephone Number : 909-594-9303
Provider Enumeration Date : 07/12/2007
Last Update Date : 07/12/2007

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